In October of last year the Augusta Victoria Hospital in East Jerusalem became the first Palestinian hospital to open a school for seriously ill children in its care. The Persistence School caters for children arriving from the West Bank and Gaza in need of cancer treatment and kidney dialysis. The children range from first to twelfth grade and learn Arabic, English, Maths, and Science.

The children at the Persistence School are forced to come to Jerusalem for treatment because their access to resources in the West Bank and Gaza are so limited. The Israeli blockade of Gaza, in particular, has strictly limited the importation of medical equipment and supplies into the Strip. Hospitals like Augusta Victoria in East Jerusalem therefore provide a vital service.

Hiba Sonokrot, the Persistence School’s English teacher, told Palestine Monitor how important the school is for children facing the unique struggle of getting access to life-saving medical treatment under occupation. The patients, or “students”, as Sonokrot prefers to call them, must travel back and forth to the West Bank and Gaza for the duration of their treatment. This displaces them from the routines of life and school that their friends are able to enjoy in their cities and villages. The purpose of the school, then, is not just to compensate for the hours the students must miss from their regular education, but also to offer an environment that makes them feel purposeful and positive in spite of their illness.

The children in need of dialysis must attend the hospital for three to six hours, three times a week. These students do not ever stay at the hospital and so, depending on where they live in the West Bank (dialysis patients do not come from Gaza), they spend a considerable amount of time each week either travelling or sitting idle in the hospital. Sonokrot says this is a very difficult situation for them and that the school provides them with much needed stimulation: “It actually makes them more powerful, more confident. [They think,] 'I am studying here, I am not only sitting and doing nothing – I am like other students.’”

For the students requiring treatment for cancer, they usually stay at the hospital for one to two weeks at a time. They then travel back to the West Bank or Gaza, returning again for extended intervals as their treatment requires, often for up to six months.

Compounding the difficulties of living such a disjointed life, the children suffering from cancer are unable to go to school in the periods they spend at home because their immune systems are too fragile. In such cases, the teachers at the Persistence School give the children exercises to do away from the hospital. The Persistence School also coordinates with the child’s local school to ensure the children are staying as up-to-date as possible with their classmates. For the children arriving from Gaza, however, communication with a child or their school becomes extremely difficult once the child is back at home.

Paradoxically, for the children who are unable to attend school when they are at home, coming to the hospital can actually be something to look forward to. Sonokrot says, “when a student is sick, he actually feels like he is not a normal person, so he wants to feel like he is a normal kid. So, actually, they love to study.” The hospital becomes a place that gives the children a sense of connectedness to the normal, purposeful life of a child attending school.

Sonokrot says she was amazed when she first started working at the Persistence School because of just how much the children wanted to go to class. She says, “When we open the school at eight [in the morning] it’s very beautiful for them. They feel like, 'oh we have to go and study – let’s go’ … they go actually immediately when they see us walk in the corridors. They come after us.” Amazingly, the children always come to the schoolroom before going to the playroom, says Sonokrot.

The experience of coming to the hospital is, of course, not without its difficulties. For the children travelling from Gaza, accessing the treatment they need at the hospital can be particularly difficult. Sonokrot says it sometimes takes up to seven hours for a one-way trip between the child’s home and the hospital. Even though the hospital provides them with transport, they are subjected to heavy scrutiny at checkpoints and are often held up for long periods of time.

Palestinians residing in Gaza have been increasingly denied permits to cross the border for medical treatment in recent years. B’Tselem has reported that the rate of permit approval for Palestinians leaving Gaza for medical treatment declined from 81.99% in 2014 to 76.60% in 2015, and 65.95% in 2016. Earlier this year, the World Health Organization reported that this figure had dropped to 46.95%.

Furthermore, of those who were approved permits in January, only 61.4% of their companions were approved to travel with them. For the children of Gaza receiving treatment at Augusta Victoria Hospital, this figure holds a particular implication. An added stressor of their trip to Jerusalem is that they must often travel and receive treatment without the comfort of their parents. This is because their parents usually fall within an age bracket deemed to be a security liability by Israeli authorities. In these cases, a child’s grandparent is usually allowed to accompany the child and stay with them at the hospital.

Difficulties such as these mark the experiences of the seriously ill children of Palestine as being unique in comparison to many other children. In turn, staff members of the Persistence School hold a unique position. Far from their homes, families and friends, the children look to Hiba Sonokrot and her colleagues for a special kind of support: “We have to not only be teachers but nurses and psychologists, sometimes.”

Sonokrot admits that it can be difficult to hold this position with the children while watching them deteriorate under the rigours of their treatment. Despite wanting to study and to maintain active lives, the children are usually unable to do more than half an hour of study at a time. Even so, Sonokrot says she and her colleagues are inspired by the way the children strive to better themselves and lead lives that are as normal as possible. Sonokrot says that the relationship between the staff and the students is not one of one-way care. In her own words, “They support us.”

Following the success of the Persistence School, the Augusta Victoria hospital has already put into motion a plan to expand its education facilities from a single classroom into a whole corridor. When asked whether she thought the example made by the Persistence School would spread elsewhere in Palestine, Sonokrot responded smilingly: “I’m very sure!” Plans are already underway to open a similar facility at a hospital in Beit Jala, she says, and there have been suggestions of schools opening in other hospitals throughout Palestine.